Kalyani Samudra, MD in Salt Lake City, UT - Medicare Psychiatry & Neurology

Kalyani Samudra, MD is a medicare enrolled "Psychiatry & Neurology - Child & Adolescent Psychiatry" physician in Salt Lake City, Utah. Her current practice location is 501 S Chipeta Way, Artec South Campus, Second Floor, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 585-1575.

Kalyani Samudra is licensed to practice in Utah (license number 6079971-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1528035748.

Contact Information

	Kalyani Samudra, MD
	501 S Chipeta Way, Artec South Campus, Second Floor, Salt Lake City, UT 84108-1222
	(801) 585-1575
	(801) 569-9718

Map and Direction

Physician's Profile

Full Name	Kalyani Samudra
Gender	Female
Speciality	Psychiatry & Neurology - Child & Adolescent Psychiatry
Location	501 S Chipeta Way, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528035748
Provider Enumeration Date: 03/07/2006
Last Update Date: 11/17/2021

Medicare PECOS Information:

PECOS PAC ID: 1850417619
Enrollment ID: I20100929000882

Medical Identifiers

Medical identifiers for Kalyani Samudra such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528035748	NPI	-	NPPES
60799711200001	Other	UT	BLUE CROSS PROVIDER #

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084P0800X	Psychiatry & Neurology - Psychiatry	6079971-1205 (Utah)	Secondary
2084P0804X	Psychiatry & Neurology - Child & Adolescent Psychiatry	6079971-1205 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kalyani Samudra allows following entities to bill medicare on her behalf.

Entity Name	University Of Utah Behavioral Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740688613 PECOS PAC ID: 9537483607 Enrollment ID: O20150120001118

Entity Name	University Of Utah Acuity Care Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407250541 PECOS PAC ID: 4789908534 Enrollment ID: O20150127000392

Entity Name	University Of Utah Pediatric Acuity Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619325131 PECOS PAC ID: 6406148345 Enrollment ID: O20160713000869

Entity Name	University Of Utah Pediatric Behavioral Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649631599 PECOS PAC ID: 3870886898 Enrollment ID: O20160727002309

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kalyani Samudra is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kalyani Samudra, MD Po Box 413076, Salt Lake City, UT 84141-3076 Ph: (801) 213-3900	Kalyani Samudra, MD 501 S Chipeta Way, Artec South Campus, Second Floor, Salt Lake City, UT 84108-1222 Ph: (801) 585-1575

Reviews and Comments

Psychiatry & Neurology Doctors in Salt Lake City, UT

Dr. Eric Thayne Monson, MD, PHD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096
Dr. Gerald Martin Lazar, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2005 E 2700 S, Suite 180, Salt Lake City, UT 84109 Phone: 801-746-2297 Fax: 801-322-3890
Muharrem B. Baytunca, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-4096
Leah M. Fortson, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Huntsman Mental Health Institute, 501 Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-4096
Christopher R. Sweeney, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-7951 Fax: 801-581-5604
Norman L. Foster, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-585-6387
Dr. Amy Gallop Weagley, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 501 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-581-2121

Kalyani Samudra, MD - Medicare Psychiatry & Neurology in Salt Lake City, UT